Final Project Presentation

This storyboard delivers the final project product by exhibiting the final project in pages.

Data Visualization Project

Data Visualization Project

Storytelling with Data

Prescription Drug Pricing in the United States: Analyzing the Concrete and Abstract

Abigail Burns

Sharon Jepkosgei

Chizoma Oparaji

Jannelle Marie Navales

Introduction

This project is about visualization of the public spending on saving environment.

Purpose

This project is about visualization of the spending on prescription drugs and effect of regulations.

Background

  • More than 131 Million people (66% of adults) in the US use prescription drugs

  • Prescription drugs are vital to maintain/improve health

  • The rising cost of prescription drugs = overburdened public healthcare systems and individual family budgets across the country

  • Affordability & accessibility is vital

Research Question

How do changes in prescription drug policies and regulations impact the affordability and accessibility of prescriptions?

Research Hypothesis

Prescription drug policies and regulations have had a measurable impact on affordability and accessibility of prescriptions

Philosophy

  • More like Wickham’s approach (not Tufte’s simplicity)

  • Layered Approach - building visualizations through layers (adding scales and aesthetics)

  • Customization - Customize visualizations extensively, allowing for fine-tuned control over every aspect of a chart.

  • Interesting and eye-catching visualizations

Statins

Warning: package 'ggplot2' was built under R version 4.3.2

  • The prices of various prescription have been on the rise in the past decades

  • These are some of the commonly used medications

Statins- used to lower cholesterol levels

  • The highest between 2014 and 2018

Inhalers


Case Study: Diabetes Prescriptions


Rising Prices

  • Over the past two decades pharmaceutical manufacturers have increased list prices on insulin each year
  • Over 9 million Americans rely on insulin, and they have been raising red flags over soaring prices for years.

Trend

  • From January 2014 to April 2019

  • The average cash price per insulin unit rose 54%

  • Then, from January 2020 to July 2023, it dropped by 10.6%.

Diabetes Prescription Use Over time


High costs, High risks

  • A drop in diabetes medication use in 2018

  • The high cost of insulin forced many people to ration the medication

  • People in the U.S. either skip, delay or use less insulin than was needed in the year to save money

  • Rationing can have dire consequences.

Comparing with Other Countries: 2018

Warning: package 'tidyverse' was built under R version 4.3.2
Warning: package 'shadowtext' was built under R version 4.3.2
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ℹ Please use the `linewidth` argument instead.
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Analysis

  • We found a possible explanation for the drop in diabetes prescription use in 2018.

  • According to the chart, in 2018, the average list price for one vial of insulin in the U.S. was $98.70

  • Up to 10 times more than other countries in the OECD.

Why is this important

  • People with Type 1 diabetes need, on average 1 to 3 vials of insulin per month. 

  • Patients with Type 2 diabetes don’t always need to take insulin, but those who do can sometimes require more than people with Type 1 diabetes.

Insulin Regulation

Inflation Reduction Act (IRA)

  • It went into effect in January 2023

  • Patients who are covered under the Medicare Part D plan now have a $35 out-of-pocket monthly cap for their insulin.

  • Higher rebates, even exceeding 100% of a drug’s price, in cases when manufacturers have raised list prices sharply over time and have offered substantial rebates triggering large best price discounts.

    Effect of IRA on Manufacturers

    Under the IRA, manufacturers will face penalties in Medicare for raising list prices faster than inflation

Impact of Legislation: Consumers

# Plot states with graduated colors representing annual savings
choropleth <- (
  ggplot(data = map, 
         aes(fill = `Average Annual Out-of-Pocket Savings Per Enrollee ($)`)) + 
    labs(fill = "Average Annual Out-of-Pocket \nSavings Per Enrollee ($)") + 
    theme(plot.title = element_text(hjust = 0.5),
          panel.grid.major = element_blank(), 
          panel.grid.minor = element_blank(), 
          axis.title.x=element_blank(), 
          axis.text.x=element_blank(), 
          axis.ticks.x=element_blank(), 
          axis.title.y=element_blank(), 
          axis.text.y=element_blank(), 
          axis.ticks.y=element_blank()
    ) + 
    geom_sf() + 
    geom_sf_text(aes(label = `STATE_ABBR`), size = 3) + 
    coord_sf(xlim = c(-165, -70), ylim=c(21,62)) + 
    scale_fill_gradientn(colours = brewer.pal(5, "Greens"),
                         labels = c("$300", "$400","$500","$600","$700", "$800")
                         ) + 
    ggtitle("Inflation Reduction Act: Major Savings for Americans Who Use Insulin") + 
    guides(fill = FALSE)
)
Warning: The `<scale>` argument of `guides()` cannot be `FALSE`. Use "none" instead as
of ggplot2 3.3.4.
ggplotly(choropleth, tooltip="Average Annual Out-of-Pocket Savings Per Enrollee ($)")
Warning in st_point_on_surface.sfc(sf::st_zm(x)): st_point_on_surface may not
give correct results for longitude/latitude data

The map shows the estimated out-of-pocket savings if IRA had been in effect in 2020, by state

  • webscraped data from report

-total savings to beneficiaries - $734 million in Part D and $27 million in Part B

  • an average savings of approximately $500 for those Medicare beneficiaries.

  • The states with the most people with Medicare projected to benefit from the new IRA insulin cost savings:

Texas -114,000 beneficiaries

California -108,000

Florida -90,000

  • Highest average annual out-of-pocket savings

North Dakota - $805

Iowa - $725

South Dakota - $725

Impact of Legislation: Corporations

[1] "LLY"

Impact of regulation:

  • Facing pressure to curb diabetes-treatment costs, Eli Lilly & Co. announced on March 1 that it is slashing insulin prices

  • They immediately capped the out-of-pocket cost of all of its insulin at $35 a month.

  • The graph shows Eli Lilly & Co. stock prices from June 2022 to most recent data

  • From the graph reduction in insulin price has not affected the bottom line of Eli Lilly & Co.

Future impact

  • IRA only applies to those with Medicare

  • But, medicare is the largest single purchaser of prescription drugs in the US.

  • This might further deter drug makers from increasing prices each year while offering greater rebates to insurers.

Impact of Legislation: Corporations

[1] "NVO"

  • Novo Nordisk and Sanofi are other dominant insulin manufacturers that announced they have drastically lowered list prices and out-of-pocket costs in March 2023.

  • Novo Nordisk stock prices have an upward trend

Impact of Insurance

Warning: Ignoring 5 observations

The graph shows how affordability of prescription medication varies by:

  • insurance, coverage type, and income.

  • Affordability problems increase as income falls and are much higher among those without insurance coverage.

  • People with diabetes enrolled in high-deductible plans report greater affordability problems than those in conventional private insurance plans.

Affordability


The Affordable Care Act (ACA)

  • Prices increased rapidly between 2007 and 2017

  • But, coverage expansions reduced the share of those with diabetes in each income group who reported difficulty affording prescription drugs.

  • The greatest declines have been among people with incomes between 100 percent and 300 percent of the federal poverty level

Takeaways

Our analysis suggests that the most important factors affecting the affordability of insulin:

  • the availability of coverage

  • the form of that coverage

People with adequate coverage are often shielded from these price increases.

Medicaid expansion

people with diabetes who can enroll in Medicaid are protected from:

  • high out-of-pocket costs for prescription

  • high costs for other dimensions of their care